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[Prophylactic effect of systemic ceftazidime on bacterial translocation in scalded rats].

In this study, we evaluated the prophylactic effect of Ceftazidime on bacterial translocation (BT) of Pseudomonas aeruginosa in scalded rat by qualitative and quantitative bacterial cultures of blood, organs and mesenteric lymph nodes (MLN). Ceftazidi-me was administered systemically at 3 h, 6 h and 12 h post injury respectively. The dynamic changes in levels of Ceftazidime in blood and organ tissues were also determined. The results showed that effective levels of Ceftazidime in blood, liver and mucosa of the small intestine were rapidly reached and maintained for more than 4 h, but no drug was found in MLN. The prophylactic effect on BT was significant when systemic administration started at 3 h post injury (P < 0.001) and 6 h post injury (P < 0.05). Although the incidence of BT was unchanged (P > 0.05) when systemic administration started at 12 h, the number of organisms present in livers and kidneys, except MLN, was dramatically reduced (P < 0.01).

Animals↗

Late complications of scalding in children: treatment and prevention.

Children between the ages 1 to 3 years are particularly prone to burns by their constant desire to pull down containers of hot fluids. The resulting burns produce serious complications such as hypertrophic scars and scar contractures, which can be severe enough to cause growth disturbances. A series of 31 cases of these accidents resulting in the above sequelae was investigated. These complications are however the end result of a chain of unfortunate events any or all of which could have been avoided. Usually the scald could have been prevented by greater vigilance on the part of the parents. Once late complications have developed, excision of the scar tissue and subsequent skin grafting or other reconstructive procedure should be performed. However, in spite of satisfactory results, these complications have a tendency to recur during the growth period.

Burns↗

Exposure of buttock burn wounds to stool in scald-abused infants and children: stool-staining of eschar and burn wound sepsis.

Between July 1, 1987 and June 30, 1990, 30 consecutive deliberately scalded children with buttock involvement were prospectively studied. Mean age was 22.5 months. Mean burn size was 18.1 per cent TBSA (total body surface area). Thirty per cent (n = 9) had diarrhea complicate their wound or autograft care. For those requiring surgery for their buttock/perineal burns, various combinations of preoperative mechanical bowel prep, oral antibiotics, postoperative occlusive intrarectal catheter, nothing-by-mouth, and rigid postoperative positioning did not protect buttock wounds and autografts from stool. Four patients had stool staining of the superficial burn wound exudate, none of whom developed burn wound sepsis or died. Four (13.3%) patients with a mean burn size of 32.3 per cent TBSA, diarrhea, and burns involving the buttock, perineum, and external genitalia died of burn wound sepsis, three of whom had deep stool staining of their burn wound and Gram-positive bacteremia. Buttock burn wounds should be examined carefully and frequently for the presence of deep stool staining, an ominous predictor of burn wound sepsis and death. Such wounds, if present, should be emergently excised.

Bacteremia↗

[Early changes in cardiac function and beta-ARs in heart after severe scalds in rat].

The changes in left ventricular function and ventricle beta-adrenoceptors (beta-ARs) were measured in rat undergoing a full thickness scalded burn of skin of 30% total body surface area. The results showed that there were a significant decrease in left ventricular systolic pressure (LVSP), maximum rising and falling rate of left intraventricular pressure (LV +/- dp/dtmax) and density of ventricular beta-ARs. Correlation analysis showed that the change in beta-ARs density correlated with the change in LVSP, LV +/- dp/dtmax positively.

Animals↗

Staphylococcal scalded skin syndrome in an adult and a child.

Two patients had staphylococcal scalded skin syndrome (SSSS) with typical clinical and histopathologic findings. In both cases, the disease was reproduced by injections of staphylococci into mice. The adult patient, who had no other physical or laboratory abnormalities, showed intact humoral and cellular immunity; her uneventful clinical course was clearly different from the eight previously reported cases in adults. To our knowledge, the child represents the first case report of SSSS as a result of infection by a non-group 2 Staphylococcus.

Adult↗

Staphylococcal scalded skin syndrome (SSSS) and consecutive septicaemia in a preterm infant.

Staphylococcal scaled-skin syndrome (SSSS) is a toxin-related epidermolytic disease that usually affects infants and children under 5 years. We report herein a case of a premature infant who had developed SSSS after an infection of the pharynx with staphylococci and who died of septicaemia due to pseudomonas aeruginosa. The primary mechanism of action of epidermolysin still remains unknown. We demonstrate that acantholysis is due to an early edema of the intercellular space with separation of ultrastructurally unaltered desmosomes.

Humans↗